1669405940 NPI number — CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC

Table of content: (NPI 1669405940)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669405940 NPI number — CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLAIRE ZANG, PSYCHOTHERAPIST, LCSW, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669405940
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 GOLDEN HILL STREET
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-243-0929
Provider Business Mailing Address Fax Number:
203-331-8288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 GOLDEN HILL STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-243-0929
Provider Business Practice Location Address Fax Number:
203-331-8288
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZANG
Authorized Official First Name:
CLAIRE
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOTHERAPIST
Authorized Official Telephone Number:
203-243-0929

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  004352 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 048768102 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 140004352CT03 . This is a "ANTHEM BLUE CROSS BLUE SH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 297496 . This is a "MHN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C03276 . This is a "MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 7354466 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004236312 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 453920 . This is a "VALUE OPTIONS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2949830 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11546151 . This is a "CAQH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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